Individual
DR. DEBRA A ZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
200 ALFRED ST, MICHIGAN CITY, IN 46360
(219) 872-6200
(219) 879-2915
Mailing address
710 FRANKLIN ST STE 200, MICHIGAN CITY, IN 46360-3564
(219) 872-6200
(219) 879-2915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02001389
IN
207Q00000X
Family Medicine Physician
Primary
02001389A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100366040
—
IN
Enumeration date
11/07/2005
Last updated
03/12/2024
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